THE LIVER. 1707 



Surfaces. In its natural form, as shown in specimens hardened before removal 

 from the body, the liver presents five surfaces. The superior surface is in the 

 main convex, looking upward beneath the diaphragm. The anterior surface, directed 

 forward, is continuous with the former, on the hardened liver a fairly distinct line 

 marking the change of direction that separates them. The right surface faces 

 towards the right and is separated in a similar way from the superior. It passes 

 insensibly into the anterior surface. In a flaccid liver, in which the normal form has 

 been lost, these three surfaces are indistinguishable, constituting the old superior 

 surface. In the hardened organ the three represent a dome, of which the flattened 

 upper surface is slightly separated from the others. The posterior surface is on the 

 back of the right lobe. The inferior surface is moulded over the organs beneath it. 



The borders are best described from the posterior surface as a starting-point. 

 The upper border of the latter separates it from the superior and right surfaces ; the 

 lower border from the inferior. On the right these meet at a mor~ or less acute 

 angle. On the left the posterior surface narrows to a border, first thick and then 

 sharp, which runs around the liver, separating first the upper and lower surfaces of the 

 left lobe and later the lower from the anterior and right ones, until finally it reaches 

 the right end of the lower border of the posterior surface. Along the front of the 

 liver the border is sharp and directed downward, overhanging the concave lower 

 surface. A conspicuous incision, the umbilical notch (incisura umbilicalis), in the 

 anterior border marks the place at which a sickle-like fold of peritoneum, t\\& falci- 

 form ligament, conveying the obliterated umbilical vein, now the round ligament 

 (ligaraentum teres hepatis), to the lower surface, reaches the liver. The falciform 

 ligament is continued back between the top of the liver and the diaphragm, and marks 

 off on the anterior and superior surfaces a large right lobe and a small left one. 



The superior surface (Fig. 1440) includes the upper part of both lobes and is 

 moulded to the opposed surface of the diaphragm. The top of the right lobe fills 

 in the w'hole of the space below the corresponding half of the diaphragm, but the 

 left lobe does not usually reach the walls of the abdomen, unless in front. It may, 

 however, touch the left wall. Well-hardened livers show a slight cardiac depression 

 on the left lobe beneath the heart. The posterior border of the superior surface is 

 marked on the right lobe by the reflection of the peritoneum onto the diaphragm 

 above the triangular posterior surface, and on the left by the rounded posterior 

 border of the liver. 



The right and anterior surfaces lie against the diaphragm, except where 

 the anterior rests against the abdominal wall between the costal arches, and offer 

 little for description. 



The posterior surface (Figs. 1441, 1456), on the back of the right lobe, con- 

 sists of a triangular non-peritoneal area and of the lobe of Spigelius. The former, 

 adherent to the diaphragm, extends from the inferior vena cava to the right, where 

 it ends in the point formed by the meeting of the upper and lower borders. The 

 greatest vertical dimension of the non-peritoneal area is not over 7.5 cm. (3 in. ), and 

 the transverse not over 12.5 cm. (5 in. ). A triangular hollow at the lower border of 

 this space, just to the right of the vena cava, receives the right suprarenal capsule, 

 which rests also on the lower surface. To the left of this depression is a deep furrow 

 for the inferior vena cava, which sometimes at the top is converted into a canal. Still 

 farther to the left is the lobe of Spigelius ( lobus caudatus ) , a four-sided prism placed 

 vertically on the back of the liver, bounding a part of the lesser cavity of the perito- 

 neum. The lower end, which hangs free, is continuous on the right with the caudate 

 lobe (processus caudatus). It often presents on the left of the lower end a distinct 

 tubercle, the tuber papillare (His), which is by no means constant. The Spigelian 

 lobe lies between the fossa of the vena cava on the right and the fissure of the ductus 

 venosus on the left. The latter joins the former in front of this lobe, just below the 

 diaphragm, so that the lobe ends in a point above. It more or less encircles the vena 

 cava, sometimes meeting the right lobe behind it. The vena cava is frequently over- 

 lapped by a projection from the right lobe, and sometimes the overlapping is done 

 both by this and by the lobe of Spigelius. The prismatic shape of the latter is well 

 shown by transverse sections. The amount of attachment to the rest of the liver 

 varies, and the shape of the lobe with it. Sometimes the fissure of the ductus 



